RESECTION OF MALIGNANT PRIMARY LIVER-TUMORS

BACKGROUND: Malignant primary liver tumors are an uncommon and challen ging surgical problem, In spite of multimodality therapies, surgical r esection remains the mainstay of treatment and the most likely chance for cure, We reviewed the 13-year resection experience of a single sur geon at our institution to evaluate the results. METHODS: A retrospect ive review from July 1982 to June 1995 was performed for patients pres enting with a diagnosis of primary liver cancer, Those undergoing rese ction of their primary liver tumors form the basis of this report. RES ULTS: One hundred eighty-four patients with a diagnosis of primary liv er cancer were seen at our institution, Of these, 43 patients underwen t 46 resections of their cancers by a single surgeon, There were 22 fe males (51%) and 21 males (49%). The average age was 61 years with a me dian age of 63 years (range, 19-85 years), Tumors resected included 27 hepatomas, 16 cholangiocellular carcinomas, 1 carcinoid tumor, 1 low grade mucinous cystadenocarcinoma, and 1 cystadenocarcinoma, Resection s were as follows: 9 right trisegmentectomies, 8 right lobectomies, 1 left trisegmentectomy, 4 left lobectomies, 7 left lateral segmentectom ies, and 17 partial lobectomies, Major complications occurred in 11 pa tients (26%). There were 3 deaths, for a 30-day perioperative death ra te of 7%, Of the 43 patients, 13 had follow-up of less than 12 months and 30 had follow-up for more than 1 year, The mean survival of the 30 patients who had their tumors resected and were followed up for more than 1 year was 27.2 months and the median survival was 21 months,, Th e median survival of patients not undergoing resection was less than 6 months, The 1-, 2-, 3-, and 5-year survival rates were 57%, 52%, 40%, and 33%, respectively. CONCLUSIONS: Primary liver cancer can be treat ed by resection with acceptable results, This remains the standard tre atment of any liver cancer, Survival rates of patients after resection are much better than survival rates of patients who do not undergo su rgery.